Career Opportunities at Summit Health and CityMD

Summit Health and CityMD form a physician-driven, patient-centric network, committed to simplifying the complexities of health care and bringing a more connected kind of care. Our unique network was created by the 2019 merger between Summit Medical Group, one of the nation’s premier independent multispecialty medical groups, and CityMD, the leading urgent care provider in the New York metropolitan area. Together, Summit Health and CityMD deliver a more intuitive, comprehensive, and responsive care experience for every patient, regardless of the stage of life or health condition, through high-quality primary, specialty, and urgent care.

We are continually growing to meet the needs of our patients and deliver exceptional care to an even greater population. Summit Health now has more than 2,800 providers across more than 80 specialty areas, 13,000 employees, and over 370 locations in New York, New Jersey, Connecticut, Pennsylvania, and Central Oregon. CityMD has over 150 locations across the tri-state. We share a vision of improving the way health care needs are addressed by offering timely, high-quality, comprehensive care with an exceptional patient experience. Together, we provide the best possible care to every patient in every neighborhood.

Join our team!

Summit Health and CityMD are dedicated to hiring and retaining the right talent who will contribute to our ongoing expansion and success. We work to set clear goals and expectations, while regularly managing performance and cultivating personal and team capabilities within a positive, collaborative environment that recognizes and rewards success. We strive to make each team member's experience at our company inspiring. Explore our open positions and apply to become a part of the Summit Health and CityMD family.

Job Description

The RCM Professional Coder must exhibit an understanding of coding concepts, AMA, CMS/OIG/Federal/State regulations & guidelines, benchmark standards and must have a high level of analytical and statistical skill sets to monitor the systems for data quality and integrity across the various functional applications.

This position is also responsible for tracking/monitoring areas of revenue loss, potential risk and escalating areas of concern to the Manager and Director. Additionally, the Senior Abstractor is responsible for the Department’s maintenance and data integrity of electronic files/reference tools, along with routine reporting (weekly and/or monthly) of the coding vendor’s quality and assurance reviews.

Essential Job functions:

o Assist Manger with project management of special projects as assigned and coordinating tasks with co-workers and vendors as needed.
o Develop, maintain, and implement tracking and reporting mechanisms related to Revenue Cycle initiatives and activities
o Create department specialty and individual coding vendor presentations, documentation tools, and other reference tools
o Under the direction of the Manager, manage the coding vendor workflow, custom rules, timely completion of projects, educational reviews, quality, productivity and assurance reviews, etc.
o Coordinate process for correcting claims accordingly based on final quality and assurance reviews, releasing only compliant claims for billing and manage other claims that require additional review.

• Revenue Coding Assessments/Dashboard:

o Develop and manage quality and assurance reviews
o Apply knowledge of ethical coding principles and revenue cycle activities to evaluate coding compliance with processes, potential areas of loss revenue, risk and/or areas of needed education.
o Utilize practice management system and other system applications to run reports on payer claim activity and other identified organizational areas of revenue loss, potential risks and exposure.

• Coding Vendor Educational Initiative Tracking/Report Analysis:

o Run reports for Revenue Cycle Department, Management Team and physicians as needed to communicate data of interest, work performed or ad hoc.
o Use online research tools to conduct research on assigned issues.
o Produce weekly and monthly reports to report status of Coding Vendor projects/initiatives
o Audit and abstract codes and medical record for proper assignment of diagnoses and procedure codes, E&M level according to AMA, ICD-9-CM, CPT, CMS and OIG Guidelines.
o Conduct quality and productivity reviews related to Revenue Cycle initiatives and communicates/collaborates with Manager and other teams regarding audit outcomes and educational areas of opportunity.

• Data Integrity/Reference Material:

o Participate with the creation and implementation of reimbursement related processes that may affect various disciplines of the organization to ensure accurate billing, and reimbursement
o Responsible for maintenance of Coding Vendor’s Educational Service’s “library” both electronic and hard copy references ensuring most up to date versions of Summit Health revenue cycle workflow requirements.

General Job functions:

• Other duties as required.

Physical Job Requirements:

• Endurance to work long hours on projects and educational initiatives.
• Associate’ degree required. Bachelor’s Degree preferred.
• Experience as a medical coder and as a professional fee abstractor
• Coding certification should be one or more of the following: CPC, CPC-H, CPMA, RHIT, RHIA
• Advanced knowledge of CPT-4, ICD-9, ICD-10, HCPCS
• Strong ability to work effectively with physicians and other clinical and operational staff.
• Ability to multi-task, organize & prioritize work within any given setting required.
• Ability to process a large amount and various types of data required.
• Proficient use of Microsoft Office Applications (Excel, Access, and Word) required.

Total Rewards at Summit Health CityMD

Our team members are essential to our mission to reshape healthcare through the power of connection. Summit Health highly values the critical role that health and wellness play in the lives of our team members and their families. We strive to provide a valuable suite of benefits, wellness programs, compensation, time off, and resources to support the wellbeing and personal needs of team members and their families at various stages of life and in their professional career. Collectively, we call these "Total Rewards“.

Here at Summit Health, our total rewards include, but are not limited to:

Equal Opportunity Employer

Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.

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